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BACKGROUND AND PURPOSE: Although our previous data indicated that claudin 18 isoform 2 (CLDN18.2)-targeted chimeric antigen receptor (CAR) T cells displayed remarkable clinical efficacy in CLDN18.2-positive gastric cancer, their efficacy is limited in pancreatic ductal adenocarcinoma (PDAC). The tumour microenvironment (TME) is one of the main obstacles to the efficacy of CAR-T and remodelling the TME may be a possible way to overcome this obstacle. The TME of PDAC is characterized by abundant cancer-related fibroblasts (CAFs), which hinder the infiltration and function of CLDN18.2-targeted CAR-T cells. The expression of fibroblast activation protein alpha (FAP) is an important feature of active CAFs, providing potential targets for eliminating CAFs. EXPERIMENTAL APPROACH: In this study, we generated 10 FAP/CLDN 18.2 dual-targeted CAR-T cells and evaluated their anti-tumour ability in vitro and in vivo. KEY RESULTS: Compared with conventional CAR-T cells, some dual-targeted CAR-T cells showed improved therapeutic effects in mouse pancreatic cancers. Further, dual-targeted CAR-T cells with better anti-tumour effect could suppress the recruitment of myeloid-derived suppressor cells (MDSCs) to improve the immunosuppressive TME, which contributes to the survival of CD8+ T cells. Moreover, dual-targeted CAR-T cells reduced the exhaustion of T cells in transforming TGF-ß dependent manner. CONCLUSION AND IMPLICATIONS: The dual-targeted CAR-T cells obtained enhancement of T effector function, inhibition of T cell exhaustion, and improvement of tumour microenvironment. Our findings provide a theoretical rationale for dual-targeted FAP/CLDN 18.2 CAR-T cells therapy in PDAC.
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Objective To explore the application value of ultrasonic measurement of optic nerve sheath diameter(ONSD)and cerebral blood flow parameters in intracranial hypertension caused by AIDS cryptococ-cal meningitis.Methods A total of 27 patients with cryptococcal meningitis diagnosed by Chongqing Public Health Medical Center from February to July,2022 were included.All patients were examined with ultrasound measurement of ONSD and ultrasound measurement of cerebral blood flow of intracranial middle cerebral ar-tery(MCA),including peak systolic velocity(PSV),end diastolic velocity(EDV),peak systolic velocity/end diastolic velocity(S/D)and resistance index(RI),and then lumbar puncture was performed and intracranial pressure(ICP)was recorded.The ICP≥200 mmH2O was defined as the ICP increased group,ICP<200 mmH2O was defined as the ICP normal group,and 17 AIDS patients without complications were selected as the control group.The baseline data,ONSD and MCA cerebral blood flow parameters of the three groups were compared,and the statistically significant indexes were correlated with ICP,and the receiver operating charac-teristic(ROC)curve of the subjects was drawn to analyze the diagnostic efficacy of ONSD value in predicting intracranial hypertension caused by AIDS cryptococcal meningitis.Results There were no significant differ-ences in gender,age,systolic blood pressure or diastolic blood pressure among the ICP increased group,the ICP normal group and the control group(P>0.05).There were no significant differences in PSV,EDV,S/D and RI among the three groups of MCA(P>0.05),but there was significant difference in ONSD among the three groups(P<0.05).There was a positive correlation between ICP and ONSD in the patients with AIDS cryptococcal meningitis(P<0.01,r=0.736).The ROC curve analysis showed that when the ONSD cutoff value was 3.965 mm,it predicted the highest efficacy of intracranial high pressure in the patients with AIDS cryptococcal meningitis.The area under the ROC curve was 0.90(95%CI:0.714-1.000,P=0.001),the sensitivity was 90%,and the specificity was 100%.Conclusion Ultrasonic measurement of ONSD can effec-tively predict ICP in patients with AIDS cryptococcal meningitis and guide clinical decompression measures in time,which is worthy of clinical application.
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ObjectiveTo investigate the influencing factors for the clinical outcome of patients with drug-induced liver injury (DILI), and to establish a nomogram prediction model for validation. MethodsA retrospective analysis was performed for the general information and laboratory data of 188 patients with DILI who were admitted to Heilongjiang Provincial Hospital Affiliated to Harbin Institute of Technology from January 2017 to December 2022, and according to their clinical outcome, they were divided into good outcome group with 146 patients and poor outcome group with 42 patients. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate Logistic regression analyses were used to investigate the independent influencing factors for the clinical outcome of DILI patients. R Studio 4.1.2 software was used to establish a nomogram model, and calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to perform internal validation. ResultsThe univariate Logistic regression analysis showed that liver biopsy for the diagnosis of DILI, platelet count, cholinesterase, albumin, prothrombin time activity, IgM, and IgG were associated with adverse outcomes in patients with DILI. The multivariate Logistic regression analysis showed that liver biopsy for the diagnosis of DILI (odds ratio [OR]=0.072, 95% confidence interval [CI]: 0.022 — 0.213, P<0.001), clinical classification (OR=0.463, 95%CI: 0.213 — 0.926, P=0.039), alanine aminotransferase (OR=0.999, 95%CI: 0.998 — 1.000, P=0.025), prothrombin time activity (OR=0.973, 95%CI: 0.952 — 0.993, P=0.011), and IgM (OR=1.456, 95%CI: 1.082 — 2.021, P=0.015) were independent influencing factors for clinical outcome in patients with DILI. The nomogram prediction model was established, and after validation, the calibration curve was close to the reference curve. The area under the ROC curve was 0.829, and the DCA curve showed that the model had good net clinical benefit. ConclusionThe nomogram prediction model established in this study has good clinical calibration, discriminative ability, and application value in evaluating the clinical outcome of patients with DILI.
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OBJECTIVE: The objectives of this study is to compare the prognostic differences between cystic biliary atresia (CBA) and non-CBA, analyze the clinical and liver pathological differences between the two groups, and explore the possible factors that affect the native liver survival of infants with CBA after Kasai portoenterostomy (KPE). METHODS: From 2013 to 2020, 131 infants with BA were admitted to Tianjin Children's Hospital. A total of 108 infants with BA were included after excluding those who did not undergo surgery after diagnosis (n = 23), including 12 cases of CBA and 96 cases of non-CBA. The clinical data, native liver survival and liver pathology, including liver fibrosis, bile ductular proliferation (BDP), bile plug, and portal area inflammation infiltration of the two study groups were compared. RESULTS: CBA accounts for 9.16% (12/131) and type I CBA accounts for 6.87% (9/131) of all types of BA. 16.7% (2/12) of CBA were detected prenatally with diagnosis of choledochal cyst (CC). The age at KPE, total bilirubin, direct bilirubin, and total bile acid levels of CBA were significantly lower than those of non-CBA (P = 0.047, P = 0.013, P = 0.009, P = 0.010, respectively). The long and wide diameters of the gallbladder were significantly larger than those of non-CBA (both P < 0.001). The 1-, 3-, and 5-year survival rates of CBA were 83.3%, 71.4%, and 71.4%, respectively, and 56.5%, 32.5%, and 29.8%, respectively, in non-CBA. The difference between the two groups was statistically significant (P = 0.031). The degree of liver fibrosis and bile plug in non-CBA was higher than that of CBA (P = 0.004, P < 0.001, respectively). There was no difference of BDP and inflammation infiltration between the two groups (P = 0.285, P = 0.243, respectively). CONCLUSION: CBA is a distinct type different from non-CBA, with different pathological processes, pathological manifestations, and clinical prognosis. The favorable prognosis of CBA may be derived from the early diagnosis, early operation, and mild pathological changes.
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Biliary Atresia , Choledochal Cyst , Biliary Atresia/surgery , Child , Humans , Infant , Liver/surgery , Portoenterostomy, Hepatic , Prognosis , Retrospective StudiesABSTRACT
Objective:To evaluate the efficacy of compound chamomile and lidocaine hydrochloride gel in prevention of complications related to laryngeal mask airway (LMA) insertion.Methods:Ninety American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 18-60 yr, undergoing elective surgery with ventilation using LMA under general anesthesia, were divided into 3 groups ( n=30 each) using a random number table method: paraffin oil group (group A), compound lidocaine cream group (group B), and compound chamomile and lidocaine hydrochloride gel group (group C). The paraffin oil, compound lidocaine cream, and compound chamomile and lidocaine hydrochloride gel were evenly applied on the front, shoulder and back of the LMA before inserting the LMA in A, B and C groups, respectively.The severity of sore throat, oropharyngeal mucositis score, hoarseness score and occurrence in each time period (0-1 h, >1-6 h, >6-24 h, > 24-48 h) were recorded at 1, 6, 24 and 48 h after removal of the laryngeal mask.The stress responses during removal of the LMA and occurrence of drug-related adverse reactions within 48 h after removal of LMA were recorded. Results:Twenty-nine cases in group A, 28 cases in group B and 27 cases in group C completed the trial.Compared with group A, the severity of sore throat at each time point after removal of the LMA and incidence of sore throat in each time period were significantly decreased, the oropharyngeal mucositis score at 6, 24 and 48 h after removal of the LMA and the incidence of oropharyngeal mucositis in the time period >1-48 h were decreased, and the incidence of drug-related adverse reactions was increased in group C ( P<0.05). Compared with group B, the severity of sore throat at 6 h after removal of the LMA and incidence of sore throat > 1-48 h after removal of the LMA were significantly decreased, the oropharyngeal mucositis score at 6, 24 and 48 h after removal of the LMA and incidence of oropharyngeal mucositis in the time period >1-48 h after LMA removal were reduced, and the incidence of drug-related adverse reactions was decreased in group C ( P<0.05). There was no significant difference in the hoarseness score and incidence of hoarseness after removal of the LMA and incidence of stress responses during removal of the LMA among the three groups ( P>0.05). Conclusions:Compound chamomile and lidocaine hydrochloride gel has a certain efficacy in preventing complications related to LMA placement.
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Objective@#To investigate the effects of different doses of aerobic exercise on the microvascular function of habitually sedentary college students.@*Methods@#A total of 69 students from Hubei Minzu University were recruited and divided into sports group A, sports group B and control group, with 23 students in each group (12 boys and 11 girls). The exercise group received 12 weeks of aerobic exercise intervention, in which group A exercised 1-2 times a week, group B exercised≥3 times a week, and the control group did not carry out any systematic sports. Microvascular response, Transcutaneous partial pressure of oxygen(TcpO 2), Nitric oxide, Nitric oxide synthase (NOS) and En dothelin-1 (ET-1) were measured before and after the test.@*Results@#After the test, the microvascular reactivity showed group and time interaction( P <0.01), in which exercise group B was greater than that of control group and exercise group A ( P <0.01). There was no significant difference between exercise group A and control group ( P >0.05), but the percutaneous partial pressure of oxygen ( P =0.53) had no time interaction with other groups; NO( F =6.32) and NOS( F =7.91) had group and time interaction, in which exercise group B was greater than control group and exercise group A ( P <0.01), and there was no significant difference between exercise group A and control group ( P >0.05).@*Conclusion@#There is a "dose effect" relationship between aerobic exercise and microcirculatory blood perfusion and endogenous NO. Continuous aerobic exercise ≥3 times a week for 12 weeks improved microcirculatory blood perfusion and promoted endogenous NO production in sedentary college students, but doing aerobic exercise for 1-2 times a week had no significant effect on microcirculatory blood perfusion and endogenous NO.
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Active management of the third stage of labour involves giving a prophylactic uterotonic, early cord clamping, controlled cord traction and uterine massage. Active management of the third stage, as the main package of procedure to prevent postpartum hemorrhage, can effectively shorten the third stage of labor and reduce the incidence of severe postpartum hemorrhage, this is a major cause of women dying in developing countries. In developed countries, severe bleeding occurs much less often, yet active management has become standard practice in many countries for several decades. The most common complications of active management of the third stage of labor are pain and side effects of oxytocin, in addition to serious complications such as inversion of uterus and retained placental. Therefore, in recent years, a variety of interventions have been adopted in the third stage of labour, especially for low-risk pregnant women, which have been questioned and the evidence for using active management for all women is insufficient. The purpose of this article is to compare the effectiveness and variations of different management of the third stage of labour, and provide the basis for reasonable and individualized management of the third stage of labour, ultimately promote the natural labour.
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Objective:To establish a radiomics signature based on CT images of non-small cell lung cancer (NSCLC) to predict the expression of molecular marker P63.Methods:A total of 245 NSCLC patients who underwent CT scans were retrospectively included.All patients were confirmed by histopathological examinations and P63 expression were examined within 2 weeks after CT examination.Radiomics features were extracted by MaZda software and subjective image features were defined from original non-enhanced CT images.The Lasso-logistic regression model was used to select features and develop radiomics signature,subjective image features model,and combined diagnostic model.The predictive performance of each model was evaluated by the receiver operating characteristic (ROC) curve,and compared with Delong test.Results:Of the 245 patients,96 were P63 positive and 149 were P63 negative.The subjective image feature model consisted of 6 image features.Through feature selection,the radiomics signature consisted of 8 radiomics features.The area under the ROC curves of the subjective image feature model and the radiomics signature in predicting P63 expression statue were 0.700 and 0.755,respectively,without a significant difference (P>0.05).The combined diagnostic model showed the best predictive power (AUC=0.817,P<0.01).Conclusion:The radiomics-based CT scan images can predict the expression status of NSCLC molecular marker P63.The combination of the radiomics features and subjective image features can significantly improve the predictive performance of the predictive model,which may be helpful to provide a non-invasive way for understanding the molecular information for lung cancer cells.
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Active management of the third stage of labour involves giving a prophylactic uterotonic, early cord clamping, controlled cord traction and uterine massage. Active management of the third stage, as the main package of procedure to prevent postpartum hemorrhage, can effectively shorten the third stage of labor and reduce the incidence of severe postpartum hemorrhage, this is a major cause of women dying in developing countries . In developed countries, severe bleeding occurs much less often, yet active management has become standard practice in many countries for several decades. The most common complications of active management of the third stage of labor are pain and side effects of oxytocin, in addition to serious complications such as inversion of uterus and retained placental. Therefore, in recent years, a variety of interventions have been adopted in the third stage of labour, especially for low-risk pregnant women, which have been questioned and the evidence for using active management for all women is insufficient. The purpose of this article is to compare the effectiveness and variations of different management of the third stage of labour, and provide the basis for reasonable and individualized management of the third stage of labour, ultimately promote the natural labour.
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Objective To study the effect of hypertonic sodium chloride in the treatment of patients with traumatic hemorrhagic shock and the effects of NO and neutrophil surface CD 18 on the serum.Methods 120 patients with traumatic hemorrhagic shock were admitted to the hospital from December 2013 to December 2016,and randomly divided into the observation group and the control group.The control group was given nal-oxone injection,while the observation group was given hypertonic Sodium Chloride Solution.The two groups were compared before and after treatment,hemoglobin concentration,total infusion,24 h mortality,recovery time and adverse reactions,and the patients′hemodynamic and NO and CD18 levels were measured on the ser-um.Results After 24 h treatment,the observation group total infusion was(1 203.13 ± 117.82)mL,the re-covery time was(60.73 ± 5.63)min,24 h mortality rate of 5.00% was significantly lower than the control group total infusion(1 672.38 ± 123.64)mL,the recovery time(71.82 ± 6.19)min,24 h death rate 16.67%, hemoglobin concentration(91.24 ± 5.71)g/L higher than that of the control group(79.45 ± 6.18)g/L,the difference was statistically significant(P<0.05).Before treatment,there was no difference in the contents of NO and CD18 between the two groups.After treatment,two groups of patients with serum NO,CD18 content significantly decreased,but the observation group NO(20.27 ± 6.65)mol/L,CD18(41.67 ± 13.24)ng/mL were significantly lower than the control group NO(29.12 ± 8.23)mol/L,CD18(52.64 ± 13.51)ng/mL,the difference were statistically significant(P<0.05).Before treatment,two groups of patients with hemodynam-ic indexes of arterial and venous pressure,no difference in heart rate(P> 0.05);after treatment,the two groups of patients with arterial and venous pressure and heart rate were improved,but the change index of the observation group than in the control group was stable,the difference was statistically significant(P<0.05). The complication rate of the observation group was 10%(6/60),which was significantly lower than that of the control group(15/60),and the difference was statistically significant(P<0.05).Conclusion The infiltra-tion of sodium chloride intravenous infusion could significantly decreased CD 18 and NO levels in the serum of the patients,the patients with stable hemodynamics,reduced the incidence of complications,worthy of clinical reference.
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Objective To compare the rates and pathological features of diabetic keratopathy in mice induced by single high dose or multiple low dose streptozotocin (STZ) injections.Methods Eighty male C57BL/6 mice (6-8 weeks old) were randomly divided into 4 groups with each group contain 20 mice:normal control group,multiple low dose 1 month group and multiple low dose 3 months group (injected with 60 mg/kg STZ for 5 consecutive times),single high dose 1 month group (injected with 150 mg/kg STZ).The survival rate,model success rate,body weight,glycosylated hemoglobin (HbA1c) content were compared among different modeling group.The percentages of residual epithelial defect area were examined by fluorescein sodium staining after removal of central corneal epithelium.The expression of p-Akt,Sirt1 and Ki67 were evaluated by immunofluorescent staining.The corneal sensitivity were compared among different groups before corneal epithelial curettage,3,7,10 and 14 days after corneal epithelial curettage.The corneal subbasal nerve density at 14 days after corneal epithelial curettage were compared among different groups.This study complied with the declaration of ARVO Results The success rate of diabetic modeling in multiple low dose 1 month group,multiple low dose 3 months group and single high dose 1 month group was 90%,80% and 70%,respectively.The HbA1c levels in the diabetic modeling groups were significantly higher than that in the normal control group (all at P<0.05).The percentage of residual epithelial defect area 24 and 48 hours after corneal epithelial curettage in the multiple low dose 3 months group and single high dosc 1 month group were significantly higher than those in the normal control group (all at P<0.05).The fluorescence intensity of p-Akt,Sirt1 and Ki67 in the multiple low dose 3 months group and single high dose 1 month group were stronger than those in the normal control group.There were no significant differences on corneal sensitivity and corneal nerve density between normal control and multiple low dose 3 months group before and 14 days after the corneal epithelial removal (all at P>0.05).However,the corneal sensitivity and corneal nerve density were dramatically decreased in the multiple low dose 3 months group and single high dose 1 month group before and 14 days after the corneal epithelial removal,and there were significant differences compared with normal control group (all at P<0.05).Conclusions The injection of 60 mg/kg STZ can not induce the features of diabetic keratopathy in mice within 1 month.However,the mice of both 1 month after 150 mg/kg STZ injection and 3 months after 60 mg/kg STZ injection appear the typical epithelial and nerve features of diabetic keratopathy,therefore can be the ideal animal models for research.
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Objective To explore the CT and MRI performances of primary extragonadal seminoma .Methods The imaging find‐ings of primary extragonadal seminoma in 16 patients proved by histopathology were analyzed retrospectively .The tumor location , size ,contour ,periphery ,density or signal and contrast enhancement patterns were evaluated ,and these were compared with the pathological results .Results The lesions in 16 patients were solitary including the ovoid lesions in 6 and lobulated ones in 10 .They were located in intracranial area in 10 patients ,anterior middle mediastinum in 4 and abdomen in 2 .Mean size of the tumors was(7 .0 ± 5 .6) cm (ranging from 1 .3 cm to 18 .6 cm) .Unenhanced CT in 13 patients showed the soft tissue masses with necrosis in 8 ,stip‐pled calcification in 2 and hemorrhage in 2 .Enhanced CT in 6 patients showed homogeneity in 2 and heterogeneity in 4 ,and the de‐grees of enhancement increased gradually .The plain and enhanced MRI in 10 patients showed iso‐or slight hypointensity on T1WI and slight hyperintensity on T2 WI in 8 lesions ,heterogeneous enhancement in 7 and slight enhancement in one ,peripheral enhance‐ment in 2 due to central hemorrhage .Pathology showed most of the lesions were well‐vascularized with inner cystic change .Tumor stroma was divided by the fibrovascular tissue .Conclusion The imaging findings of primary extragonadal seminoma are not specific , CT ,MRI can demonstrate the invasive extent accurately .
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Objective To characterize the expressions of androgen receptor (AR) and estrogen receptor (ER) in penis skin of patients with congenital hypospadias. Methods Dorsal prepuce, ventral prepuce, and urethral plate were harvested from 30 patients with congenital hypospadias. The expressions of AR and ER in epidermal cells and dermal fibroblasts were assessed respectively by automated immunohistochemistry. Image Pro plus 6.0 was used to analyze the optical density (OD) value of AR and ER in different parts of epidermal cells and dermal fibroblasts. Results AR and ER were located mainly in nucleis of the squamous basal cells and prickle cells, and were also found in nucleis of subcutaneous fibroblast cells. The expression of AR was lower in epidermis of urethral plate than that of dorsal prepuce and ventral prepuce (P<0.05), but no significant difference was detected in dermal fibroblasts. The expression of ER was higher in epidermis of dorsal prepuce than that of urethral plate and ventral prepuce (P<0.05). The dermal expression of ER in fibroblast cells was increased successively in dorsal prepuce, ventral prepuce and urethral plate (P<0.05). Conclusion Lower expression of AR in urethral plate may contribute the development of hypospadias. Disorder of ER in dermal fibroblast cells of prepuce may play an important role in hypospadias.
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Purpose To study the values of liver histopathological assessment grading score in differential diagnosis between biliary atresia ( BA) and infantile hepatitis ( IHS) . Methods Thirty four cases of BA and sixteen cases of IHS were analyzed retrospectively, which were diagnosed by biopsy. A hepatic histopathological assessment grading score was developed. This consisted of eight features such as cholestasis, hepatocellular damage, bile duct proliferation, portal edema, portal inflammation, portal fibrosis, extramedullary hemopoiesis and multinucleated giant hepatocytes. The total scores were 24 points. All the cases were assessed one by one. Results The total scores of BA were significantly higher than that of IHS (P<0. 001). The frequencies of bile duct proliferation, portal fibrosis and portal edema were significantly higher in BA than that in IHS group, while the frequency of multinucleated giant hepatocytes was significantly higher in IHS than that in BA group. Conclusions This scoring system is helpful in differentiating BA from IHS.
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This paper was aimed to study the method of rapid determination of total flavonoids in Chrysanthemum of different processing methods by near infrared spectroscopy (NIRS). The Chrysanthemum was dried by three different processes. The three methods were directly drying, drying after steamed and drying after fry, respectively. The determination of total flavonoids in Chrysanthemum by different processing methods was produced by using UV-Vis spectrophotometry. Collecting the NIRS spectra of Chrysanthemum, the quantitative analysis model of total flavonoids content in Chrysanthemum of different processing methods was established by partial least square (PLS) and the model was validated. The correlation coefficient (R2), the root-mean-square error of calibration (RMSEC) and the root-mean-square error of prediction (RMSEP) were 0.996 19, 0.104 and 0.168, respectively. The correlation coefficient of predication (r) was 0.979 3 which state that the prediction was accurate. The method of NIRS had the advantage of fast determination, simple operation and high accuracy of prediction, and could be used for rapid determination of total flavonoids content in Chrysanthemum of different processing methods.
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OBJECTIVE@#To explore the diagnostic value of the proposed thyroid imaging reporting and data system (TI-RADS) classification in thyroid nodules, and to investigate interobserver variability among different observers using TI-RADS classification for ultrasound.@*METHOD@#We reviewed 667 thyroid nodules conventional ultrasound image data from 532 patients who were confirmed by Pathological diagnosis. Those ultrasound images were reviewed by 4 experienced sonographers who can independently assessed the sonographic characteristics and analyzed according to the TI-RADS classification. It is to assess the diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the TI-RADS classification. The multirater kappa statistics were used to assess the interobserver agreement among different observers.@*RESULT@#The overall sensitivity, specificity, negative predictive value (NPV) and Accuracy were 94%, 79%, 97% and 81%, respectively. Positive predictive values (PPVs) for categories 4 and 5 were 55% and 92%. There was substantial interobserver agreement for categories 3, 4B and 5 (Kappa = 0.62, 95% CI, 0.58-0.65), and was moderate agreement for category 4A (Kappa = 0.57) and 4B(Kappa = 0.60).@*CONCLUSION@#The diagnostic criteria of TI-RADS for differentiating between benign and malignant thyroid nodules have a high diagnostic value. There was substantial interobserver agreement in different experienced sonographers. The TI-RADS diagnostic criteria have a high diagnostic value and has great practical value in making a proper and further treatment plan.
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Humans , Observer Variation , Predictive Value of Tests , Sensitivity and Specificity , Thyroid Nodule , Classification , Diagnostic Imaging , UltrasonographyABSTRACT
To enable students to better grasp the basic skills of pathogenic biology and im-munology experimental teaching , and make full use of the characteristics of experimental teaching to train students' scientific quality and innovative consciousness , the reform of pathogenic biology and immunology experiment teaching was explored. Microbiology, Parasitology and Immunology experiment were integrated into an experimental course , and corresponding laboratory was set up to take an in-dependent experimental teaching. Through renewing experiment teaching idea, some measures were taken such as modularization and personalization of the teaching content, the establishment of a com-plete management system , writing a new experimental course to match the experiment , improving teaching methods and developing students' innovative experiments to improve their enthusiasm and in-terest for experimental class learning, thus enhancing their innovation ability.
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Objective To analyze the clinic data of peripheral CIK cell increased abnormally in adults and discuss the function of the laboratory indexes on disease diagnosis ,monitoring and therapeutic intervention .Methods The peripheral blood of patients was collected to analysis .The flow cytometry instrument was used to detect lymphocyte subgroup .every patient was conducted bio‐chemical analysis ,function of blood coagulation tests and examination of marrow cell and the patient′s medical record was analyzed retrospectively .Results The total number of leukocyte and the percentage of lymphocyte in peripheral blood of patient were in‐creased;immunophenotyping results showed that lymphocytes was mainly T lymphocyte ,T8 cell number was increased and number of T4 cell was decreased;CIK(CD3+56+ ) cells were in the majority .the number of CIK cells was decreased after treatment and ranged from 28 .6% to 59 .7% .there was no obvious anomaly in examination of marrow cell before and after treatment .TNF‐α,IgM were increased mildly ,C4 was decreased mildly ,and other indicators were no obviously abnormal .Conclusion It is the first time that cases with CIK cells idiopathic increased .The monitoring of flow T lymphocyte subgroup can provide clinical diagnosis ,effect monitoring and it is worth to promote .
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Objective To explore diagnosis and treatment of biliary hypoplasia with huge choledochal cyst in infants.Methods From Feb 2003 to Dec 2011,278 choledochal cyst cases were treated in our hospital.There were 3 infant cases of biliary hypoplasia with huge extrahepatic choledochal cyst diagnosed and treated during this period.All patients underwent cholangiogram demonstrating patent,but markedly diminutive extrahepatic biliary structures.After excision of the cyst,hepatic duct was injured in 1 case.The cyst wall was removed,a stent was put inside of hepatic duct,and Roux-en-Y hepaticojejunostomy was porformed.Results All three patients (ages from 1 month to two months) received the Roux-en-Y hepaticojejunostomy,none of our patients has developed stenosis and fistula of the Roux-en-Y hepaticojejunostomy.Intraoperative cholangiogram showed the huge choledochal cyst and diminutive intrahepatic ducts.All three cases were followed-up for 1-5 years,there was no jaundice and nor stones formation.Conclusions In cases of huge choledochal cyst when intraoperative cholangiogram demonstrates a diminutive biliary tree with huge choledochal cyst,great care is required during cyst excision in order not to injury the hepatic duct.Stent placement into hepatic duct helps bile flow at early stage after surgery.
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Objective To study the effect of thermo-radiotherapy on multidrug resistance (MDR) and levels of intracellular adriamycin (ADM) in tongue squamous cell carcinoma cell line Tca 8113 and its MDR cell line Tca 8113/CBDEA. Methods Samples of the two cell lines were treated with thermo-radiotherapy (42℃ for 0.5 h and 2 Gy of radiation). Four and 24 hours later, the expression of the MDR relative proteins P-glycoprotein (P-gp),multidrug resistance associate protein 1 (MRP1) and glutathione s-tranferase-π (GST-π) were detected using immu-nohistochemistry. Intracellular ADM concentrations were measured using an HTS 7000 Plus bioassay reader. Re-sults No change in the expression of P-gp was observed in the Tca 8113/CBDEA and Tca 8113 cell lines after 4 or 24 hours. Expression of MRP1 was not significantly altered in the Tca 8113/CBDEA cell line, but there was a signifi-cant drop in the Tca 8113 cell line 24 hours post-thermo-radiotherapy. Expression of GST-π was not altered in either the Tca 8113/CBDEA or the Tca 8113 cell line at 4 hours post-thermo-radiotherapy, but there was a significant de-crease at 24 hours. At both 4 and 24 hours, drug tolerance had decreased and intracellular drug concentration had in-creased significantly in both cell lines. Conclusions Thermo-radiotherapy can enhance the effects of chemotherapy and suppress the expression of MDR factors induced by radiation. The combination of hyperthermia and radiotherapy does not induce MDR.